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Physician age and patient outcomes

BMJ 2017; 357 doi: (Published 16 May 2017) Cite this as: BMJ 2017;357:j2286
  1. Linda H Aiken, Claire M Fagin leadership professor of nursing1,
  2. Joshua H Dahlerbruch, research fellow1
  1. 1Center for Health Outcomes and Policy Research, School of Nursing, University of Pennsylvania, 418 Curie Boulevard, 387R Philadelphia, PA 19104-4217, USA
  1. Correspondence to: L H Aiken laiken{at}

New research reports a link, but the underlying mechanism remains unclear

Advances in research on patient outcomes and greater availability of detailed standardized administrative data on healthcare outcomes, particularly for patients admitted to hospital, enable examination of the performance of providers and health systems from new perspectives. In a linked paper, Tsugawa and colleagues (doi:10.1136/bmj.j1797) devised a creative research design to exploit these resources to take a fresh and informative look at the association between physician age and patient outcomes with reference to 30 day hospital mortality, readmissions, and medical care costs.1

Their focus was a US national sample of elderly Medicare patients with serious medical illnesses who required admission to hospital and whose care was provided by a hospitalist physician, defined as a general internist who filed at least 90% of total “evaluation and management” billings in an inpatient hospital. The hospitalist in the US is a relatively new medical specialty since the mid-1990s.2 Within any given hospital, patients treated by a specific hospitalist, the authors argue, are “plausibly quasi-randomized” by patients’ time of admission …

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